CurrentCareFirstPolicy N/A

Standard Approved Ambulatory Surgery Center (ASC) Codes

List of ASC procedure codes approved by CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. for reimbursement in an ASC setting; codes not listed are not eligible for payment. Applies to providers billing CareFirst for ASC services.

Policy Summary

PayerCareFirst

PolicyStandard Approved Ambulatory Surgery Center (ASC) Codes

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJan 1, 2026

Next Review DateN/A

Key ActionBill only codes listed in this document for ASC reimbursement; codes not listed are not eligible for payment.

SourceLink

POLICY UPDATE CHANGES

No material clinical or coverage changes in this revision.

2026-01-01effective date for listed codes

exempt *special coding note

hundredsASC code mappings listed

855-258-6518language assistance phone

Coverage and ASC Eligibility

ASC code mapping reference

This section provides mapping/equivalency relationships for CPT codes when billed in an Ambulatory Surgery Center (ASC) setting; it is a billing reference.

When a CPT code from the ASC list is billed in the ASC setting, apply the code-to-code mappings and equivalency pairings as shown in the mapping tables (partial examples shown in chunks 18 and 37).

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Approved ASC codes

This section provides the standard approved ASC CPT/HCPCS codes and code-to-code mappings for ambulatory surgery billing (partial list shown).

Lists of CPT and HCPCS procedure codes shown in chunks 36-55 are approved for ASC reimbursement and include code-to-code equivalencies and mappings (partial entries present).

Codes marked with an asterisk (*) in the lists are exempt from multiple procedure reduction as indicated in the document (see chunks 0 and mapping entries where * appears).

Examples of specific approved codes and mappings (partial): 45303 mapped to multiple equivalents (45303, 1 = 46040; 45303, 2 = 47534; ...), 62355* mapped to multiple codes (62355* = 62360; 62355* = 63001; ...), and 67715 equivalencies (67715 = 67808; ...; 67715 = 68130).

Codes, Mappings, and Equivalencies

Standard Approved ASC Codes (partial)mixedCovered

multiple (see chunks 0-19)

List of CPT/HCPCS ASC procedure codes approved for ASC reimbursement effective January 1, 2026; some codes marked with * are exempt from multiple procedure reduction

ASC approved code mappings (sample)CPTCovered

26480	Example CPT code appearing in ASC mapping list
37290	Example CPT code with multiple equivalencies listed
40650	Example CPT code with multiple equivalencies listed

ASC codes and mappings (partial list from document)CPTCovered

44180	Listed ASC code
45303	Listed ASC code with multiple mappings
53446	Listed (marked with *)
62355	Listed with multiple mapped codes and * markers

ASC code equivalenciesCPT

67715

mapped/equivalent to a set of ASC procedure codes (e.g., 67808, 67830, 67835, 67840, 67875, 67880, 67882, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67912, 67914, 67916, 67917, 67921, 67923, 67924, 67935, 67950, 67961, 67966, 67971, 67973, 67974, 67975, 68130)

ASC code equivalencies (continued)CPT

68320	mapped/equivalent to multiple ASC procedure codes (e.g., 68325, 68326, 68328, 68330, 68335, 68340, 68360, 68362, 68371, 68500, 68505, 68510, 68520, 68525, 68540, 68550, 68700, 68720, 68745, 68750, 68770, 68810, 68811, 68815, 68816, 69110, 69120, 69140, 69145, 69150, 69205, 69300)
69310	mapped/equivalent to multiple ASC procedure codes (e.g., 69320, 69421, 69424*, 69436, 69440, 69450, 69501, 69502, 69505, 69511, 69530, 69550, 69552, 69601, 69602, 69603, 69604, 69610, 69620, 69631, 69632, 69633, 69635, 69636, 69637, 69641, 69642, 69643, 69644, 69645, 69646, 69660)

ASC code equivalencies including HCPCSmixed

69661

mapped/equivalent to multiple ASC procedure codes and HCPCS (e.g., 69662, 69666, 69667, 69670, 69676, 69700, 69710, 69711, 69714, 69716, 69717, 69719, 69720, 69726, 69727, 69728, 69729, 69730, 69740, 69745, 69801, 69805, 69806, 69905, 69910, 69915, C2638, C2639, C2640, C2641, V2785)

Mapping examples — CPT equivalency format

Mapping format exampleSome CPT codes use numbered mapping fields showing equivalencies (example from policy: '45303, 1 = 46040')

Multi-entry mappingsA single CPT (e.g., 45303) can map to multiple target codes with different mapping positions (e.g., 45303, 2 = 47534; 45303, 3 = 49496)

Numbering indicates distinct equivalenciesThe trailing number after the comma identifies a specific equivalency position rather than a modifier (e.g., '45303, 4 = 50580')

Asterisk usage in mappingsSome mapped target codes include an asterisk indicating exemption from multiple procedure reduction (example: 45308, 2 = 47537*)

Provider Billing Guidance and Actions

Billing Rule

Approved ASC codes and reimbursement eligibility

The following list of Standard Approved ASC Codes are approved by CareFirst BlueCross BlueShield and CareFirst BlueChoice, Inc. (collectively, 'CareFirst') and eligible for reimbursement in an ASC setting. Codes not listed are not eligible for payment. The codes with an asterisk(*) are exempt from multiple procedure reduction. These codes are effective as of January 1, 2026.

Codes listed in this document (chunks 0-19 and following) are eligible for ASC reimbursement effective 2026-01-01.
Codes not listed in the ASC code tables are not eligible for payment in an ASC setting.
Codes marked with * are exempt from multiple procedure reduction.

Billing Rule

ASC code mappings (equivalencies for ASC billing)

CareFirst publishes ASC CPT code pairings and equivalencies to guide ASC billing; when reporting ASC services follow the listed code mappings/relationships provided in the document.

Examples in the mapping list show paired relationships (e.g., '26480, 27035 = 27060').
Mappings function as billing reference equivalencies for ASC claims submission.

Billing Rule

ASC approved codes listing

CareFirst provides a listing of standard approved ASC CPT/HCPCS codes and their code-to-code mappings for ambulatory surgery billing; providers must bill using the approved codes and mappings in this list.

The approved codes and mapping fields appear throughout the ASC code list (see chunks 36–56 for partial entries).
Some codes include numbered mapping fields (e.g., '45303, 1 = 46040') to indicate multiple equivalencies.

Billing Rule

Standard Approved Ambulatory Surgery Center (ASC) Codes — equivalencies (example: 67715)

This section lists ASC code equivalencies showing that certain CPT codes are considered equivalent for ASC billing (example: 67715 is mapped to many related CPT codes including 67808 through 68130).

67715 is mapped/equivalent to 67808, 67830, 67835, 67840, 67875, 67880, 67882, 67900, 67901, 67902, 67903, 67904, 67906, 67908, 67909, 67911, 67912, 67914, 67916, 67917, 67921, 67923, 67924, 67935, 67950, 67961, 67966, 67971, 67973, 67974, 67975, 68130.

Billing Rule

Standard Approved Ambulatory Surgery Center (ASC) Codes (continued)

Additional ASC CPT equivalency mappings are provided; examples include 68320 mapped to numerous related CPT codes and 69310 mapped to multiple codes (some marked with *).

68320 is mapped to codes such as 68325, 68326, 68328, 68330, 68335, 68340, 68360, 68362, 68371, 68500, 68505, 68510, 68520, 68525, 68540, 68550, 68700, 68720, 68745, 68750, 68770, 68810, 68811, 68815, 68816, 69110, 69120, 69140, 69145, 69150, 69205, 69300.
69310 is mapped to codes including 69320, 69421, 69424* (exempt from multiple procedure reduction), 69436, 69440, 69450, 69501, 69502, 69505, 69511, 69530, 69550, 69552, 69601, 69602, 69603, 69604, 69610, 69620, 69631, 69632, 69633, 69635, 69636, 69637, 69641, 69642, 69643, 69644, 69645, 69646, 69660.

Billing Rule

Standard Approved Ambulatory Surgery Center (ASC) Codes (continued) — includes HCPCS mappings

The ASC code list continues with mappings that include HCPCS codes; for example, 69661 is mapped to several CPT codes and HCPCS entries (C2638, C2639, C2640, C2641) and to V2785.

69661 maps to CPT codes such as 69662, 69666, 69667, 69670, 69676, 69700, 69710, 69711, 69714, 69716, 69717, 69719, 69720, 69726, 69727, 69728, 69729, 69730, 69740, 69745, 69801, 69805, 69806, 69905, 69910, 69915.
69661 also maps to HCPCS codes C2638, C2639, C2640, C2641 and V2785 as shown in the ASC code list.

Definitions and Notices

ASC — Ambulatory Surgery Center (definition & scope)

DefinitionASC = Ambulatory Surgery Center; codes listed in this document are approved and eligible for reimbursement in an ASC setting; codes not listed are not eligible for payment.

ScopeApplies to providers billing CareFirst for services performed in an ASC; establishes which CPT/HCPCS procedure codes are eligible for ASC reimbursement.

Effective date for ASC listingsCodes listed are effective January 1, 2026.

Standard Approved ASC Codes — definition/explanation

What it isStandard Approved ASC Codes is the set of CPT/HCPCS procedure codes and code-to-code mappings that CareFirst approves for payment when billed in an Ambulatory Surgery Center.

PurposeServes as the billing reference for ASC reimbursement and lists equivalencies/mappings used to determine ASC-eligible codes.

FormatIncludes direct code entries and mapping pairs (some with numbered mapping fields and asterisk markers indicating exemption from multiple procedure reduction).

CareFirst identity statement

Shared business nameCareFirst BlueCross BlueShield is the shared business name of CareFirst of Maryland, Inc. and Group Hospitalization and Medical Services, Inc.

Related entitiesCareFirst of Maryland, Inc., Group Hospitalization and Medical Services, Inc., CareFirst BlueChoice, Inc., and The Dental Network, Inc. are independent licensees of the Blue Cross and Blue Shield Association.

Service marksBLUE CROSS®, BLUE SHIELD® and the Cross and Shield Symbols are registered service marks of the Blue Cross and Blue Shield Association.

Notice of Nondiscrimination and Availability of Language Assistance Services

Nondiscrimination commitmentCareFirst complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex.

Language assistance availabilityLanguage assistance services are available; members should call the phone number on the back of their ID card or the number provided to access interpreters at no cost.

Grievance assistanceIf you believe CareFirst failed to provide these services or discriminated, you can file a grievance with the Civil Rights Coordinator; assistance is available to help file a grievance.

Civil Rights Coordinator contact & grievance instructions

Civil Rights Coordinator — phone410-528-7820

Civil Rights Coordinator — emailcivilrightscoordinator@carefirst.com

Civil Rights Coordinator — mailing addressP.O. Box 14858, Lexington, KY 40512

Fax number and grievance filingFax: 410-505-2011. To file a grievance about civil rights violations, contact the Civil Rights Coordinator by mail, fax or email; assistance is available to help file a grievance.

Policy Summary

PayerCareFirst

PolicyStandard Approved Ambulatory Surgery Center (ASC) Codes

Policy CodePolicy N/A

Change TypeNo material changes

Effective DateJan 1, 2026

Next Review DateN/A

Key ActionBill only codes listed in this document for ASC reimbursement; codes not listed are not eligible for payment.

SourceLink

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